STOP — Contraindicated
🔴 STOP — Contraindicated. Do not take St. Johns Wort with Duloxetine. This combination can cause serious harm or death.
Evidence level: STRONG
Do not combine St. John's Wort with Cymbalta. The serotonin overload can cause Serotonin Syndrome.
Dual serotonergic activity. Duloxetine (SNRI) + St. John's Wort = excessive serotonin.
Do NOT take St. Johns Wort and Duloxetine together under any circumstances. If you are currently taking both, contact your doctor or pharmacist immediately — do not stop either medication abruptly without medical guidance.
Take Duloxetine at a consistent time daily. St. Johns Wort can be taken with a meal. Similar to SSRIs, SNRIs affect serotonin — avoid botanicals with serotonergic properties (St. John's Wort, SAMe) unless cleared by your prescriber. Adaptogens like ashwagandha or rhodiola are generally safer alongside SNRIs.
Risk increases with higher doses of either substance, older age, liver or kidney impairment, and concurrent use of other serotonergic or CNS-depressant substances.
Agitation, confusion, rapid heartbeat, high blood pressure, dilated pupils, muscle twitching, diarrhea, high body temperature, seizures. Seek emergency care immediately.
Show this page to your doctor. Ask: "I want to take St. Johns Wort but I'm on Duloxetine. What safe alternatives do I have?"
Consider talking to your doctor about adjusting your antidepressant dose rather than adding St. Johns Wort. Safer supplement options for mood support include magnesium glycinate, omega-3 fish oil, or vitamin D3 — all with strong evidence and minimal drug interactions.
Do not combine St. John's Wort with Cymbalta. The serotonin overload can cause Serotonin Syndrome.
Take Duloxetine at a consistent time daily. St. Johns Wort can be taken with a meal. Similar to SSRIs, SNRIs affect serotonin — avoid botanicals with serotonergic properties (St. John's Wort, SAMe) unless cleared by your prescriber. Adaptogens like ashwagandha or rhodiola are generally safer alongside SNRIs.
Agitation, confusion, rapid heartbeat, high blood pressure, dilated pupils, muscle twitching, diarrhea, high body temperature, seizures. Seek emergency care immediately.
Consider talking to your doctor about adjusting your antidepressant dose rather than adding St. Johns Wort. Safer supplement options for mood support include magnesium glycinate, omega-3 fish oil, or vitamin D3 — all with strong evidence and minimal drug interactions.
Show this page to your doctor. Ask: "I want to take St. Johns Wort but I'm on Duloxetine. What safe alternatives do I have?"
Or browse the full interaction database (121,000+ pairs).